MECHANISM OF ABNORMAL WATER EXCRETION IN SCHIZOPHRENIA

总体目标是建立阶段性水机制 醉酒在慢性精神分裂症中非常常见，在 特别是为了确定水平衡中的责任缺陷是否 与精神病有关，就其本身而言。初步研究确定了两个 多发性糖尿病、低钠尿症慢性患者的基础水排出异常 精神药物与匹配的非糖尿病、正常血症者的比较 精神控制。其中一个异常是肾功能的缺陷。 一种是稀释尿液，另一种是渗透调节 下丘脑激素，精氨酸加压素(AVP)。异常情况是 没有严重到足以解释更严重的低钠血症的发作 伴随着水中毒。 第一项拟议的研究将评估一种特殊的反应是否 抗精神病药物通过决定水分平衡而导致这些基础异常。 服用和停用抗精神病药的多发性、低钠血症慢性精神病患者 与正常对照组相比。第二项研究将确定， 相反，慢性多饮通过比较水来引起这些异常。 慢性精神病患者低钠血症的平衡；多发性正常血压症 与多饮严重程度相匹配的精神病患者和正常对照组。这个 第三项研究将评估渗透调节的基础异常 在严重低钠血症的自发性发作期间恶化，如果这 恶化伴随着血浆高香草酸(HVA)的增加 以及精神病的恶化。水平衡、血浆HVA与精神病 将评估多发性糖尿病、低钠血症精神病患者的基本情况 在严重低钠血症的自发性发作期间。 这些研究应该澄清基础异常的病因。 慢性阻塞性肺疾病患者水排泄与水中毒的关系 精神病；可能有助于改善水紊乱的治疗 代谢，并可能进一步了解神经化学基础。 精神分裂症。

The overall goal is to establish the mechanism of episodic water intoxication that occurs so commonly in chronic schizophrenia and, in particular, to determine if the responsible defects in water balance are linked to the psychosis, per se. The preliminary study identified two basal abnormalities in water excretion in polydipsic, hyponatremic chronic psychotics when compared to matched non-polydipsic, normonatremic psychiatric controls. One abnormality was a defect in the kidney's capacity to dilute urine, and the other was in the osmoregulation of the hypothalamic hormone, arginine vasopressin (AVP). The abnormalities were not severe enough to account for the episodes of more severe hyponatremia that accompany water intoxication. The first proposed study will evaluate whether an idiosyncratic response to neuro-leptics causes these basal abnormalities by determining water balance in polydipsic, hyponatremic chronic psychotics on and off neuroleptics compared to normal controls. The second study will determine whether, instead, chronic polydipsia causes these abnormalities by comparing water balance in hyponatremic chronic psychotics; polydipsic normonatremic psychotics matched for severity of polydipsia; and normal controls. The third study will evaluate whether the basal abnormality in osmoregulation worsens during spontaneous episodes of severe hyponatremia, and if this worsening is accompanied by an increase in plasma homovanillic acid (HVA) and exacerbation of the psychosis. Water balance, plasma HVA, and psychosis ratings will be assessed in polydipsic, hyponatremic psychotics under basal conditions and during a spontaneous episode of severe hyponatremia. These studies should clarify the etiology of the basal abnormalities in water excretion as well as the episodes of water intoxication in chronic psychotics; may contribute to improved treatment of disorders of water metabolism; and may further understanding of the neurochemical basis of schizophrenia.